Displaying publications 141 - 160 of 236 in total

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  1. Zaini NNM, Salleh WMNHW, Arzmi MH, Salihu AS, Ab Ghani N
    Nat Prod Res, 2023 Dec 26.
    PMID: 38146623 DOI: 10.1080/14786419.2023.2298720
    The chemical composition, antifungal, antibiofilm, and molecular docking studies of the essential oil obtained from Lindera caesia were investigated. A total of thirty-nine components (96.7%) were identified using gas chromatography (GC-FID) and gas chromatography-mass spectrometry (GC-MS). The major components included terpinen-4-ol (26.3%), neo-intermedeol (23.2%), eudesma-4,11-dien-3-one (10.4%), and o-cymene (5.3%). The antifungal activity was tested against Candida albicans and Streptococcus mutans using the broth microdilution assay, whereas the microbial biofilms were determined using a semi-quantitative static biofilm. The essential oil exhibited activity against C. albicans (MIC 125 µg/mL) and S. mutans (MIC 250 µg/mL), and increased the biofilm of C. albicans by 31.25% when treated with 500 µg/mL. The molecular docking study shows neo-intermedeol, eudesma-4,11-dien-3-one, α-selinene, and β-selinene as the good candidate to target Erg11 with a binding energy of -7.3 kcal/mol. These findings demonstrated that the essential oil may have potential in dental application for caries prevention.
  2. Sarian MN, Zulkefli N, Che Zain MS, Maniam S, Fakurazi S
    Turk J Biol, 2023;47(4):236-246.
    PMID: 38152620 DOI: 10.55730/1300-0152.2659
    A skin wound or perforation triggers a series of homeostatic reactions to safeguard internal organs from invasion by pathogens or other substances that could damage body tissues. An injury may occasionally heal quickly, leading to the closure of the skin's structure. Healing from chronic wounds takes a long time. Although many treatment options are available to manage wound healing, an unmet therapy need remains because of the complexity of the processes and the other factors involved. It is crucial to conduct consistent research on novel therapeutic approaches to find an effective healing agent. Therefore, this work aims to cover various in vitro and in vivo methodologies that could be utilised to examine wound recovery. Before deciding on the optimal course of action, several techniques' benefits, drawbacks, and factors need to be reviewed.
  3. Mohd Sahardi NFN, Jaafar F, Tan JK, Mad Nordin MF, Makpol S
    Nutrients, 2023 Oct 25;15(21).
    PMID: 37960173 DOI: 10.3390/nu15214520
    (1) Background: Muscle loss is associated with frailty and a reduction in physical strength and performance, which is caused by increased oxidative stress. Ginger (Zingiber officinale Roscoe) is a potential herb that can be used to reduce the level of oxidative stress. This study aimed to determine the effect of ginger on the expression of metabolites and their metabolic pathways in the myoblast cells to elucidate the mechanism involved and its pharmacological properties in promoting myoblast differentiation. (2) Methods: The myoblast cells were cultured into three stages (young, pre-senescent and senescent). At each stage, the myoblasts were treated with different concentrations of ginger extract. Then, metabolomic analysis was performed using liquid chromatography-tandem mass spectrometry (LCMS/MS). (3) Results: Nine metabolites were decreased in both the pre-senescent and senescent control groups as compared to the young control group. For the young ginger-treated group, 8-shogaol and valine were upregulated, whereas adipic acid and bis (4-ethyl benzylidene) sorbitol were decreased. In the pre-senescent ginger-treated group, the niacinamide was upregulated, while carnitine and creatine were downregulated. Ginger treatment in the senescent group caused a significant upregulation in 8-shogaol, octadecanamide and uracil. (4) Conclusions: Ginger extract has the potential as a pharmacological agent to reduce muscle loss in skeletal muscle by triggering changes in some metabolites and their pathways that could promote muscle regeneration in ageing.
  4. Kamil NN, Xiao S, Syed Salleh SN, Xu H, Zhuang CC
    Heliyon, 2024 Aug 15;10(15):e35798.
    PMID: 39170218 DOI: 10.1016/j.heliyon.2024.e35798
    Oil palm contributes to various global needs as one of the most productive oil crops, but there exist ongoing concerns regarding its yield reductions and associated environmental impacts resulting from land conversion. This is the first detailed report investigating the nonlinear threats to estate-level oil palm yields posed by El Niño Southern Oscillation (ENSO) in the equatorial Pacific Ocean, a major driver of climate variability. Using the Malaysian Palm Oil Board administrative records on monthly performances reported by oil palm estates through the e-submissions portal spanning from January 2015 to June 2023, we focused on elucidating the impacts of ENSO on fresh fruit bunch yield, oil extraction rate, and oil yield. We found that both El Niño and La Niña conditions, characterized by extreme levels of ENSO indices cumulated over lags of 0-23 months prior to harvest, were associated with statistically significant reductions in yields. Lag association patterns unveiled that production risks were linked to pre-harvest exposure to extreme ENSO indices in various time windows. Subgroup analyses further revealed that the effects were pronounced in labor-intensive estates and those lacking fertilizer investments. This study underscores the necessity for adaptation strategies in response to future climate anomalies.
  5. Hasan IH, Ismail I, Hamidon MN, Mustaffa MS, Abdullah NH, Shafiee FN
    Heliyon, 2024 Nov 30;10(22):e39966.
    PMID: 39584123 DOI: 10.1016/j.heliyon.2024.e39966
    Carbon nanotube-Yttrium iron garnet (CNT-YIG) nanohybrid has been successfully synthesized using chemical vapor deposition (CVD) with yttrium iron garnet (YIG) nanopowders as catalyst, ethanol as carbon stock, and argon as carrier gas. Carbon nanotube (CNT) was observed to have grown from the YIG nanopowders with bamboo-like structures of CNT at a synthesis temperature of 900 °C. FESEM and RAMAN characterization indicated that the CNT-YIG nanohybrid exhibited the growth of bamboo-like CNT with high graphitization. Further analysis of electrical properties showed that the CNT-YIG nanohybrid has exhibited conductivity due to the CNT growth. The nanohybrid in the form of powders was then mixed with an organic vehicle to produce thick film paste and screen-printed onto a substrate as the working material for patch antenna application. Initial measurements using VNA indicated that CNT-YIG nanohybrid gave significant results regarding return loss and bandwidth, proving that the materials could have great potential to enhance patch antenna performance due to their combined electrical and magnetic properties.
  6. Lokanathan Y, Omar N, Ahmad Puzi NN, Saim A, Hj Idrus R
    Malays J Med Sci, 2016 Jan;23(1):4-14.
    PMID: 27540320 MyJurnal
    Centella asiatica, locally well known in Malaysia as pegaga, is a traditional herb that has been used widely in Ayurvedic medicine, traditional Chinese medicine, and in the traditional medicine of other Southeast Asian countries including Malaysia. Although consumption of the plant is indicated for various illnesses, its potential neuroprotective properties have been well studied and documented. In addition to past studies, recent studies also discovered and/or reconfirmed that C. asiatica acts as an antioxidant, reducing the effect of oxidative stress in vitro and in vivo. At the in vitro level, C. asiatica promotes dendrite arborisation and elongation, and also protects the neurons from apoptosis. In vivo studies have shown that the whole extract and also individual compounds of C. asiatica have a protective effect against various neurological diseases. Most of the in vivo studies on neuroprotective effects have focused on Alzheimer's disease, Parkinson's disease, learning and memory enhancement, neurotoxicity and other mental illnesses such as depression and anxiety, and epilepsy. Recent studies have embarked on finding the molecular mechanism of neuroprotection by C. asiatica extract. However, the capability of C. asiatica in enhancing neuroregeneration has not been studied much and is limited to the regeneration of crushed sciatic nerves and protection from neuronal injury in hypoxia conditions. More studies are still needed to identify the compounds and the mechanism of action of C. asiatica that are particularly involved in neuroprotection and neuroregeneration. Furthermore, the extraction method, biochemical profile and dosage information of the C. asiatica extract need to be standardised to enhance the economic value of this traditional herb and to accelerate the entry of C. asiatica extracts into modern medicine.
  7. Ismail UN, Yahya N, Wan Zaidi WA, Law ZK, Abdul Manan H
    Front Neurosci, 2024;18:1437130.
    PMID: 39605795 DOI: 10.3389/fnins.2024.1437130
    The growing interest in complementary interventions for stroke recovery necessitates the need for neural insights to aid in making evidence-based clinical decisions. This systematic review examined the brain activation effects of complementary therapies, including acupuncture (n = 5), motor imagery therapy (MIT) (n = 5), music (n = 3), and virtual reality (VR) interventions (n = 3), on clinical outcomes and neural activity in stroke patients. All therapies engaged motor and sensory networks, frontal regions, parietal regions, and temporal regions, suggesting their potential to improve motor control, attention, memory, and cognitive function. Acupuncture activated motor areas in both hemispheres, while MIT stimulated frontoparietal regions in both sides of the brain, supporting whole-body integration in recovery. In contrast, VR therapy exhibited ipsilesional lateralization, while music therapy showed left-lateralization. The review also found that increased interhemispheric connectivity between motor regions, along with intrahemispheric ipsilesional connectivity between motor, cognitive, and sensory areas, is key to achieving better clinical outcomes.

    SYSTEMATIC REVIEW REGISTRATION: http://www.crd.york.ac.uk/PROSPERO, identifier (ID: CRD42023455192).

  8. Ahmed S, Tan YH, Mubarak NM, Khalid M, Channa N, Karri RR, et al.
    Environ Res, 2025 Jan 04;268:120765.
    PMID: 39761786 DOI: 10.1016/j.envres.2025.120765
    Bismuth-based photocatalysts proved to have remarkable photoactivity for antibiotic degradation from water. However, the two significant challenges of bismuth-based photocatalysts are the fast charge recombination rate and higher energy band gap. This study successfully synthesised a novel I-Bi/Bi2WO6/MWCNTs (C-WBI) heterostructure composite photocatalysts with shorter energy band-gap and higher charge production capability through interfacial amidation linkage. The photochemical characterization of C-WBI confirms that the interfacial linkage between MWNCTs and I-Bi/Bi2WO6 (WBI) significantly boosted the charge production capacity and broadened visible-light harvesting (508 nm), resulting in improved photocatalytic activity. As anticipated, optimized 7%C-WBI shows remarkable adsorption and photocatalytic activity for TC removal compared to pristine WBI (2.27 times) under visible light. TC removal was enhanced to 96.75% from 71.58% (WBI) at mild operating conditions of pH 8, photocatalyst loading of 20 mg, and an initial TC concentration of 20 mg/l. Adsorption equilibrium was best fitted to Langmuir isotherm and pseudo-first-order kinetics with R2 of 0.998 and 0.997, respectively. In contrast, the photodegradation of TC is best described by pseudo-first-order kinetics with a correlation coefficient of 0.99 and a reaction rate of kobs of 0.0205 min-1. The effect of co-existing ions (Cl-, SO₄2⁻ and HCO₃⁻) reveals that the presence of Cl- notably inhibited the photocatalytic reaction rate, reducing it to 0.0161min⁻1. Quenching experiments identified •O₂⁻ and h⁺ radicals as key contributors to TC degradation, accounting for 63.02% and 60.8%, respectively. Furthermore, 7%C-WBI demonstrated outstanding reusability (82.05%) over 5 consecutive cycles with no obvious changes, thereby confirming the stability of the synthesised composite photocatalysts.
  9. Mohamed Z, Jit Singh GK, Dediwadon NS, Mohamad Saleh NA, Jupri NN, Ganesan Y
    Malays J Med Sci, 2022 Oct;29(5):117-125.
    PMID: 36474539 DOI: 10.21315/mjms2022.29.5.12
    BACKGROUND: Stress related to nursing education and clinical placement encounters by students since the beginning of their nursing course has been an issue of concern. This study aims to examine the prevalence of adult personality traits and their relationship with stress levels, coping mechanisms and academic performance among nursing students.

    METHODS: This cross-sectional study was conducted among 92 nursing students at Universiti Kebangsaan Malaysia (UKM). The Big Five Inventory (BFI), Student Nurse Stress Index and Brief COPE instruments were used to measure the respondents' personality traits, stress level and coping mechanisms, respectively. Data were analysed using IBM SPSS version 26.

    RESULTS: The most prevalent personality trait of the students was openness (mean = 33.58). Conscientiousness (r = -0.226, P = 0.030) and neuroticism (r = 0.326, P = 0.002) are significantly related to stress level. Extraversion (r = 0.219, P = 0.036), conscientiousness (r = 0.206, P = 0.049) and openness (r = 0.219, P = 0.036) show significant relationships with the approach coping mechanism, while agreeableness (r = -0.257, P = 0.013) and neuroticism (r = 0.297, P = 0.004) show significant relationships with the avoidant coping mechanism. However, no significant relationship was noted between personality traits and academic performance (r = 1.000, P > 0.05).

    CONCLUSION: Knowledge of ones' personality traits may benefit students in understanding themselves and in using the best ways to cope with their stress while studying nursing.

  10. Wan Mahmud WN, Hassan SA, Abd Rahman Z, Wan Abdul Wahab WNA, Ismail N
    Malays J Med Sci, 2024 Apr;31(2):188-198.
    PMID: 38694572 DOI: 10.21315/mjms2024.31.2.17
    BACKGROUND: Streptococcus pneumoniae is one of the leading causes of mortality and morbidity worldwide. The dramatic increase in in-vitro resistance of antimicrobial agents, particularly beta-lactams and macrolides, makes pneumococcal infections difficult to treat. The aim of this study was to describe the drug resistance rate, assess the prevalence of macrolide-resistant genes and review the clinical complications of pneumococcal infections among patients presented to Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia.

    METHODS: This is a descriptive cross-sectional study. All S. pneumoniae isolates collected from clinical specimens within a 1-year period were subjected to selected antimicrobial susceptibility testing using E-test strips. Polymerase chain reaction (PCR) analysis was conducted to detect macrolide-resistant determinants. The patient's clinical data were obtained from clinical notes.

    RESULTS: A total of 113 patients with a positive growth of S. pneumoniae were included in the study. The most common predisposing factors among them were bronchopulmonary diseases (15.9%). The penicillin-resistant rate was 7.1%, with minimal inhibitory concentration (MIC) ranging between 0.012 μg/mL and >32 μg/mL, and the erythromycin-resistant rate was 26.5%, with a MIC range of 0.03 μg/mL-> 256 μg/mL. Most of the erythromycin-resistant isolates were found to have the mef(A) gene (50.4%) and the erm(B) gene (20%); 16.7% had a combination of genes mef(A) and erm(B), and 13.3% had none of the two genes. Community-acquired pneumonia is the predominant type of pneumococcal infection. There was no significant association between the presence of macrolide resistance determinants and mortality (P = 0.837) or complications (P > 0.999 for empyema and cardiac complication; P = 0.135 for subdural abscess).

    CONCLUSION: The majority of erythromycin-resistant isolates were found to have the mef(A) gene, followed by the erm(B) gene and a combination of genes mef(A) and erm(B).

  11. Mohd Zainal Abidin Shukri Y, Abd Rahim IN, Abdul Nasir NA, Osman CP, Mohd Kasim NA
    PLoS One, 2025;20(1):e0315178.
    PMID: 39808674 DOI: 10.1371/journal.pone.0315178
    Cataracts are significant causes of blindness, closely linked to prolonged hypercholesterolemia. While saffron has the potential for eye health, its effects on lens lesions remain understudied. This study aimed to investigate the effect of saffron on the lens changes in atherosclerotic-induced New Zealand white rabbits (NZWR). Thirty-five NZWRs were subjected to four to eight weeks of high-cholesterol diet to induce atherosclerosis, resulting in cataractous lens changes. The rabbits were categorised randomly into three groups: normal diet group, pre-treated group and treated group. The pre-treated group was divided into early atherosclerosis(HC4) and established atherosclerosis (HC8). The saffron-treated group was fed with the HCD diet followed by saffron treatment of 50mg/kg/day (TG450, TG840) and 100mg/kg/day (TG4100, TG8100) of saffron ethanolic extract (SEE) respectively. The normal diet group was given a normal diet over the 8 weeks. After completing the 16-week experimental protocol, the NZWR were euthanized, and their lenses were extracted for histopathological evaluation. The pre-treated group exhibited cataractous lens changes of grade 2, characterized by increased homogenisation, swollen lens fibers, and intracellular vacuolisation. Interestingly, these cataract changes showed a positive trend from grade 2 to grade 1 post-treatment with SEE. In the saffron-treated group, vacuoles and pinkish homogenised areas were reduced. Additionally, a uniform layer of anterior epithelium and decreased non-swollen lens fibers indicated significant cataract lesion improvement. The normal diet group displayed minimal to zero cataractous changes (Grade 0). HPLC analysis demonstrated the presence of crocin, crocetin, and picocrocin in the saffron ethanolic extract, with peak absorptions at 440nm (12.817min), 440nm (1.620min), and 254nm (6.553min) respectively. The phytochemical screening of saffron ethanolic extract was conducted and showed the presence of phytochemical compounds including saponins, flavonoids, tannins, and steroids. The positive effects on lenses in the TG groups could be due to crocin and crocetin, bioactive components of saffron, and its phytochemical compounds. This study highlights saffron's potential in managing cataract-induced conditions, emphasizing the importance of further research for its full therapeutic potential in cataract management.
  12. Rahman ZA, Harun A, Hasan H, Mohamed Z, Noor SS, Deris ZZ, et al.
    Eye Contact Lens, 2013 Sep;39(5):355-60.
    PMID: 23982472 DOI: 10.1097/ICL.0b013e3182a3026b
    Ocular surface infections that include infections of conjunctiva, adnexa, and cornea have the potential risk of causing blindness within a given population. Empirical antibiotic therapy is usually initiated based on epidemiological data of common causative agents. Thus, the aims of this study were to determine the bacterial agents and their susceptibility patterns of isolates from ocular surface specimens in our hospital.
  13. Wahab S, Rahman FN, Wan Hasan WM, Zamani IZ, Arbaiei NC, Khor SL, et al.
    Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:82-9.
    PMID: 23857842 DOI: 10.1111/appy.12067
    Chronic stress in adolescents may cause physical, mental and emotional health issues which lead to poor outcomes if left untreated. The present study aimed to determine the prevalence of depression, anxiety and stress, and their association with stressors.
  14. Abdul PM, Jahim JM, Harun S, Markom M, Lutpi NA, Hassan O, et al.
    Bioresour Technol, 2016 Jul;211:200-8.
    PMID: 27017130 DOI: 10.1016/j.biortech.2016.02.135
    Oil palm empty fruit bunch (OPEFB) fibre is widely available in Southeast Asian countries and found to have 60% (w/w) sugar components. OPEFB was pretreated using the ammonia fibre expansion (AFEX) method and characterised physically by the Fourier transform infrared spectroscopy, X-ray diffraction and scanning electron microscopy. The results show that there were significant structural changes in OPEFB after the pretreatment step, and the sugar yield after enzymatic hydrolysis using a cocktail of Cellic Ctec2® and Cellic Htec2® increased from 0.15gg(-1) of OPEFB in the raw untreated OPEFB sample to 0.53gg(-1) of OPEFB in AFEX-pretreated OPEFB (i.e. almost a fourfold increase in sugar conversion), which enhances the economic value of OPEFB. A biohydrogen fermentability test of this hydrolysate was carried out using a locally isolated bacterium, Enterobacter sp. KBH6958. The biohydrogen yield after 72h of fermentation was 1.68mol H2 per mol sugar. Butyrate, ethanol, and acetate were the major metabolites.
  15. Hashim S, Ayub ZN, Mohamed Z, Hasan H, Harun A, Ismail N, et al.
    J Travel Med, 2016 Feb;23(2):tav019.
    PMID: 26858268 DOI: 10.1093/jtm/tav019
    BACKGROUND: Respiratory illness continues to exert a burden on hajj pilgrims in Makkah. The purpose of this study is to determine the prevalence of respiratory illness and its associated factors among Malaysian hajj pilgrims in 2013 and to describe its preventive measures.

    METHODS: A cross-sectional study was conducted in Makkah and Malaysia during the 2013 hajj season. A self-administered proforma on social demographics, previous experience of hajj or umrah, smoking habits, co-morbid illness and practices of preventive measures against respiratory illness were obtained.

    RESULTS: A total of 468 proforma were analysed. The prevalence of the respiratory illness was 93.4% with a subset of 78.2% fulfilled the criteria for influenza-like illness (ILI). Most of them (77.8%) had a respiratory illness of <2 weeks duration. Approximately 61.8% were administered antibiotics but only 2.1% of them had been hospitalized. Most of them acquired the infection after a brief stay at Arafat (81.2%). Vaccination coverages for influenza virus and pneumococcal disease were quite high, 65.2% and 59.4%, respectively. For other preventive measures practices, only 31.8% of them practiced good hand hygiene, ∼82.9% of pilgrims used surgical face masks, N95 face masks, dry towels, wet towels or veils as their face masks. Nearly one-half of the respondents (44.4%) took vitamins as their food supplement. Malaysian hajj pilgrims with previous experience of hajj (OR 0.24; 95% CI 0.10-0.56) or umrah (OR 0.19; 95% CI 0.07-0.52) and those who have practiced good hand hygiene (OR 0.35; 95% CI 0.16-0.79) were found to be significantly associated with lower risk of having respiratory illness. Otherwise, pilgrims who had contact with those with respiratory illness (OR 2.61; 95% CI 1.12-6.09) was associated with higher risk.

    CONCLUSIONS: The prevalence of respiratory illness remains high among Malaysian hajj pilgrims despite having some practices of preventive measures. All preventive measures which include hand hygiene, wearing face masks and influenza vaccination must be practiced together as bundle of care to reduce respiratory illness effectively.

  16. Talik Sisin NN, Abdul Razak K, Zainal Abidin S, Che Mat NF, Abdullah R, Ab Rashid R, et al.
    Int J Nanomedicine, 2020;15:7805-7823.
    PMID: 33116502 DOI: 10.2147/IJN.S269214
    Purpose: This study aimed to quantify synergetic effects induced by bismuth oxide nanoparticles (BiONPs), cisplatin (Cis) and baicalein-rich fraction (BRF) natural-based agent on the reactive oxygen species (ROS) generation and radiosensitization effects under irradiation of clinical radiotherapy beams of photon, electron and HDR-brachytherapy. The combined therapeutic responses of each compound and clinical radiotherapy beam were evaluated on breast cancer and normal fibroblast cell line.

    Methods: In this study, individual BiONPs, Cis, and BRF, as well as combinations of BiONPs-Cis (BC), BiONPs-BRF (BB) and BiONPs-Cis-BRF (BCB) were treated to the cells before irradiation using HDR brachytherapy with 0.38 MeV iridium-192 source, 6 MV photon beam and 6 MeV electron beam. The individual or synergetic effects from the application of the treatment components during the radiotherapy were elucidated by quantifying the ROS generation and radiosensitization effects on MCF-7 and MDA-MB-231 breast cancer cell lines as well as NIH/3T3 normal cell line.

    Results: The ROS generated in the presence of Cis stimulated the most substantial amount of ROS compared to the BiONPs and BRF. Meanwhile, the combination of the components had induced the higher ROS levels for photon beam than the brachytherapy and electron beam. The highest ROS enhancement relative to the control is attributable to the presence of BC combination in MDA-MB-231 cells, in comparison to the BB and BCB combinations. The radiosensitization effects which were quantified using the sensitization enhancement ratio (SER) indicate the highest value by BC in MCF-7 cells, followed by BCB and BB treatment. The radiosensitization effects are found to be more prominent for brachytherapy in comparison to photon and electron beam.

    Conclusion: The BiONPs, Cis and BRF are the potential radiosensitizers that could improve the efficiency of radiotherapy to eradicate the cancer cells. The combination of these potent radiosensitizers might produce multiple effects when applied in radiotherapy. The BC combination is found to have the highest SER, followed by the BCB combination. This study is also the first to investigate the effect of BRF in combination with BiONPs (BB) and BC (BCB) treatments.

  17. Yusof NY, Muhammad Yusoff F, Muhammad Harish S, Ahmad MN, Khalid MF, Mohd Nor F, et al.
    Microbiol Resour Announc, 2019 Jul 11;8(28).
    PMID: 31296668 DOI: 10.1128/MRA.00015-19
    The Gram-negative pathogenic spirochetal bacteria Leptospira spp. cause leptospirosis in humans and livestock animals. Leptospira kmetyi strain LS 001/16 was isolated from a soil sample associated with a leptospirosis patient in Kelantan, which is among the states in Malaysia with a high reported number of disease cases. Here, we report the complete genome sequence of Leptospira kmetyi strain LS 001/16.
  18. Ismail UN, Azlan CA, Khairullah S, Azman RR, Omar NF, Md Shah MN, et al.
    J Magn Reson Imaging, 2021 01;53(1):190-198.
    PMID: 33237616 DOI: 10.1002/jmri.27294
    BACKGROUND: β-thalassemia is a genetic disease that causes abnormal production of red blood cells (ineffective erythropoiesis, IE). IE is a condition known to change bone marrow composition.

    PURPOSE: To evaluate the effect of IE on the marrow fat content and fat unsaturation levels in the proximal femur using 1 H-MRS.

    STUDY TYPE: Prospective.

    SUBJECTS: Twenty-three subjects were included in this study, seven control and 16 β-thalassemia subjects.

    FIELD STRENGTH/SEQUENCE: 3.0T; stimulated echo acquisition Mode (STEAM); magnetic resonance spectroscopy (MRS) sequence.

    ASSESSMENT: Multiecho MRS scans were performed in four regions of the proximal left femur of each subject, that is, diaphysis, femoral neck, femoral head, and greater trochanter. The examined regions were grouped into red (diaphysis and femoral neck) and yellow marrow regions (femoral head and greater trochanter).

    STATISTICAL TESTS: The Jonckheere-Terpstra test was used to evaluate the impact of increasing disease severity on bone marrow fat fraction (BMFF), marrow conversion index, and fat unsaturation index (UI). Pairwise comparison analysis was performed when a significant trend (P 

  19. Perialathan K, Johari MZ, Jaafar N, Yuke Lin K, Lee Lan L, Sodri NA, et al.
    J Prim Care Community Health, 2021 5 11;12:21501327211014096.
    PMID: 33966530 DOI: 10.1177/21501327211014096
    PURPOSE: This study aimed to assess and explore perceived sustainability and challenges of the intervention among Health Care Providers (HCPs) who were involved.

    METHODS: The study applied mixed-method embedded design to analyze both quantitative and qualitative data. Quantitative approach was used to evaluate sustainability perception from 20 intervention clinics via self-reported assessment form whereas qualitative data were obtained through in-depth interview (IDI) and focus group discussions (FGDs) 14 health care professionals participated in IDI session and were either care coordinators, liaison officers (LOs)/clinic managers, or medical officers-in-charge for the clinic's intervention. Nine FGDs conducted comprised 58 HCPs from various categories.

    RESULTS: HCPs from all the 20 clinics involved responded to each listed Enhanced Primary Healthcare (EnPHC) intervention components as being implemented but the perceived sustainability of these implementation varies between them. Quantitative feedback showed sustainable interventions included risk stratification, non-communicable disease (NCD) screening form, referral within clinics and hospitals, family health team (FHT), MTAC services and mechanisms and medical adherence status. Qualitative feedback highlighted implementation of each intervention components comes with its challenges, and most of it are related to inadequate resources and facilities in clinic. HCPs made initiatives to adapt based on clinical setting to implement the interventions at best level possible, whereby this seems to be one of the core values for sustainability.

    CONCLUSION: Overall perceptions among HCPs on sustainability of EnPHC interventions are highly influenced by current experiences with existing resources. Components perceived to have inadequate resources are seen as a challenge to sustain. It's crucial for stakeholders to understand implications affecting implementation process if concerns raised are not addressed and allocation of needed resources to ensure overall successfulness and long term sustainability.

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